85. A CLER PATH TO ONBOARDING TRAINING: A NOVEL APPROACH TO PREPARE PEDIATRIC FELLOWS TO WORK AT A CHILDREN'S HOSPITAL

Abstract

Background Fellows need to be prepared for their clinical tasks to ensure safe and effective patient care. Many fellows graduate from residency and receive limited orientation for clinical learning at a new hospital. Using the ACGME's Clinical Learning Environment Review (CLER) program as a framework for instructional strategies can be an effective approach to prepare fellows for clinical work. Objective: To develop and evaluate a new interactive hospital onboarding program for pediatric fellows and to explore benefits to clinical practice 8 months after training. Design/Methods We implemented a novel Fellow Readiness Conference in alignment with CLER Pathways of Excellence to ensure fellows were well-prepared in domains of care transitions, patient safety, and physician wellness. A needs assessment evaluated the hospital's key elements of patient care for fellows, along with a review of 2018 CLER site visit data. Participants were 1st year fellows (n=64) who attended a didactic session. A post-session and 8-month follow-up survey were distributed. The Kirkpatrick Model was applied using descriptive statistics to assess Kirkpatrick Levels 1 (reaction) and 3(behavior) via means, frequencies, and histograms. Results Data from the 2 surveys are shown in Tables 1 and 2. All fellows completed the post-session survey, rating overall conference impressions as favorable (mean=3.6, SD=0.83) on a 5-point scale; 91% responded that it met or exceeded their expectations (exceeded, 41%). At 8-month follow-up 96% (26/27) of respondents indicated at least moderate confidence in applying skills learned in telephone consult communication;85% (23/27) evaluated the session as effective in helping them to apply safety practices in practice. Conclusion(s) The CLER Pathways are a valuable resource for developing a new orientation program. Our data showed benefits in several training areas, and a need to place a stronger emphasis on adverse event education. Escalation of care was added to the 2019 conference. Based on this program's success, we plan to expand the conference to add additional CLER pathways.